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Introduction: Procedural sedation (PS) is commonly performed in the emergency department (ED). Nil per os (nothing by mouth) (NPO) guidelines extrapolated from standards for patients undergoing elective procedures in the operating room have been applied to ED PS patients. There has been no large study of ED PS patients comparing differences in adverse events and PS success rates based on NPO status.Methods: From a cohort of consecutive ED PS patients of all ages in the 20 EDs of one hospital system—one quaternary ED, four tertiary EDs, six community hospital EDs, one rural ED, two pediatric EDs, and six freestanding EDs in two states in the Midwest and South—we conducted a retrospective analysis on a prospective database over 183 months from April 2000–June 2015. Primary outcome was the incidence of side effects and complications, which comprised the adverse effects. The side effects were nausea, vomiting, itching/rash, emergence reaction, myoclonus, paradoxical reaction, cough, and hiccups. Complications were oxygen desaturation

BackgroundAlthough the levonorgestrel 52 mg intrauterine device is locally active and has low systemic hormone exposure, hormonal intrauterine device users sometimes report hormone-related side effects.ObjectiveEvaluate hormone-related adverse event rates among all participants and compare these among those who used combined hormonal or no hormonal contraception in the month before enrollment.Study designA total of 1714 women aged 16 to 45 years old received a levonorgestrel 52 mg intrauterine device in a multicenter phase 3 trial to evaluate contraceptive efficacy and safety for up to 10 years. This analysis evaluated a subset of participants who used combined hormonal or no hormonal contraception in the month prior to device placement. We assessed all nonexpulsion, nonbleeding-related events with ≥1% incidence at 180 days with a plan to include weight increase regardless of incidence; we excluded events considered nonhormonal. We computed 180-day side effect frequency rates based on the number of days a side effect was reported during the study period. We created a multivariable model for side effect incidence at 180 days based on age, race, ethnicity, body mass index at enrollment, parity, and contraception use in the month before enrollment. For those side effects with a P value

BackgroundAlthough vaccines are largely effective and safe, there is variability in post-vaccination experience regarding antibody response, side effects, and affective outcomes. Vaccine mindsets, specific beliefs about the vaccine, may be associated with post-vaccination experience. This is important since mindsets are malleable and may help decrease vaccine hesitancy and improve post-vaccination experience.MethodsIn a prospective study, we measured overall positive vaccine mindset and specific mindsets regarding efficacy, body response, and side effects. We tested whether vaccine mindsets before vaccination predicted neutralizing antibody response, side effects, vaccine-related stress, and affective outcomes (general stress, sadness, and happiness). Antibody response was assessed one month and six months after participants completed a SARS-CoV-2 vaccination series. Side effect experience and affective reactions were assessed daily on the vaccination day and the subsequent five days.ResultsThere was no significant association between the aggregate vaccine mindset score and neutralizing antibody response; however, people with a more positive vaccine mindset reported fewer side effects, less same-day vaccine-related anxiety, and improved affective outcomes after vaccination. In secondary analyses, when specific mindsets were explored, the mindset that vaccine side effects are a sign of treatment efficacy predicted higher antibodies, but not side effects experience and vaccine-related anxiety. Vaccine efficacy and body-response mindsets predicted fewer side effects, vaccine-related anxiety, and improved affective outcomes after vaccination.ConclusionThese findings underscore the potential of vaccine mindsets in enhancing the overall post-vaccination experience and, in some cases, increasing antibody response.

Even though plant proteins are more plentiful and affordable than animal proteins in comparison, direct usage of plant-based proteins (PBPs) is still limited because PBPs are fed to animals as feed to produce animal-based proteins. Thus, this work has comprehensively reviewed the effects of various factors such as pH, temperature, pressure, and ionic strength on PBP properties, as well as describes the protein interactions, and extraction methods to know the optimal conditions for preparing PBP-based products with high functional properties and health benefits. According to the cited studies in the current work, the environmental factors, particularly pH and ionic strength significantly affected on physicochemical and functional properties of PBPs, especially solubility was 76.0% to 83.9% at pH = 2, while at pH = 5.0 reduced from 5.3% to 9.6%, emulsifying ability was the lowest at pH = 5.8 and the highest at pH 8.0, and foaming capacity was lowest at pH 5.0 and the highest at pH = 7.0. Electrostatic interactions are the main way for protein interactions, which can be used to create protein/polysaccharide complexes for food industrial purposes. The extraction yield of proteins can be reached up to 86–95% with high functional properties using sustainable and efficient routes, including enzymatic, ultrasound-, microwave-, pulsed electric field-, and high-pressure-assisted extraction. Nondairy alternative products, especially yogurt, 3D food printing and meat analogs, synthesis of nanoparticles, and bioplastics and packaging films are the best available PBPs-based products. Moreover, PBPs particularly those that contain pigments and their products showed good bioactivities, especially antioxidants, antidiabetic, and antimicrobial. [ABSTRACT FROM AUTHOR]

Neuropsychiatric disorders are caused by many factors and produce a wide range of symptomatic maladaptive behaviors in patients. Despite this great variance in causes and resulting behavior, we believe the maladaptive behaviors that characterize neuropsychiatric disorders are most proximally determined by networks of neurons and that this forms a common conceptual link between these disorders. Operating from this premise, it follows that treating neuropsychiatric disorders to reduce maladaptive behavior can be accomplished by modifying the patient's network of neurons. In this proof-of-concept computational psychiatry study, we tested this approach in a simple model organism that is controlled by a neural network and that exhibits aversion-resistant alcohol drinking – a key maladaptive behavior associated with alcohol use disorder. We demonstrated that it was possible to predict personalized network modifications that substantially reduced maladaptive behavior without inducing side effects. Furthermore, we found that it was possible to predict effective treatments with limited knowledge of the model and that information about neural activity during certain types of trials was more helpful in predicting treatment than information about model parameters. We hypothesize that this is a general feature of developing effective treatment strategies for networks of neurons. This computational study lays the groundwork for future studies utilizing more biologically realistic network models in conjunction with in vivo data. [ABSTRACT FROM AUTHOR]

Introduction: Most drugs fail during development and there is a clear and unmet need for approaches to better understand mechanistically how drugs exert both their intended and adverse effects. Gaining traction in this field is the use of disease data linking genes with pathological phenotypes and combining this with drugtarget interaction data. Methods: We introduce methodology to associate drugs with effects, both intended and adverse, using a tripartite network approach that combines drug-target and target-phenotype data, in which targets can be represented as proteins and protein domains. Results: We were able to detect associations for over 140,000 ChEMBL drugs and 3,800 phenotypes, represented as Human Phenotype Ontology (HPO) terms. The overlap of these results with the SIDER databases of known drug side effects was up to 10 times higher than random, depending on the target type, disease database and score threshold used. In terms of overlap with drug-phenotype pairs extracted from the literature, the performance of our methodology was up to 17.47 times greater than random. The top results include phenotype-drug associations that represent intended effects, particularly for cancers such as chronic myelogenous leukemia, which was linked with nilotinib. They also include adverse side effects, such as blurred vision being linked with tetracaine. Discussion: This work represents an important advance in our understanding of how drugs cause intended and adverse side effects through their action on disease causing genes and has potential applications for drug development and repositioning. [ABSTRACT FROM AUTHOR]

Kappa opioid receptor (KOR) agonists have well-established antinociceptive effects. However, many KOR agonists have negative side effects, which limit their therapeutic potential. Some researchers have suggested that the development of biased agonists that preferentially stimulate KOR G-protein pathways over β-arrestin pathways may yield drugs with fewer adverse side effects. This was investigated in the current study. We describe the synthesis and characterization of three U50,488 analogues, 1, 2, and 3. We evaluated the acute and chronic antinociceptive effects of these compounds in mice using the warm-water tail flick assay and in a paclitaxel-induced neuropathic pain model. Side effects were investigated using open-field, passive wire hang, rotarod, elevated zero maze, conditioned place aversion, and whole-body plethysmography, with some tests being conducted in KOR or β-arrestin2 knock out mice. All compounds were highly potent, full agonists of the KOR, with varying signaling biases in vitro. In the warm-water tail withdrawal assay, these agonists were ~10 times more potent than U50,488, but not more efficacious. All KOR agonists reversed paclitaxel-induced neuropathic pain, without tolerance. Compound 3 showed no significant side effects on any test. Signaling bias did not correlate with the antinociceptive or side effects of any compounds and knockout of β-arrestin2 had no effect on U50,488-induced sedation or motor incoordination. These findings highlight the therapeutic potential of 3, with its lack of side effects typically associated with KOR agonists, and also suggest that G-protein signaling bias is a poor predictor of KOR agonist-induced side effects. [ABSTRACT FROM AUTHOR]

Background: In the Netherlands, the use of long-acting reversible contraception (LARC) methods increases. Studies show high premature discontinuation rates of LARCs, but comprehensive insights into the Dutch situation remain limited. Aim: The aim of this study is to determine (1) the rate and reasons of discontinuation of different types of LARC in the first 2.5 years of use and (2) what patient characteristics are associated with premature discontinuation. Design and setting: Retrospective cohort study utilising data from a Dutch primary care research network. Methods: We included all women who received a LARC between 2017 and 2019 with a 2.5-year follow-up period. We performed a descriptive analysis, Kaplan Meier and logistic regression analysis to answer the research questions. Results: We included 642 women. In total, 166 women (25.9%) discontinued their LARC within 2.5 years. Discontinuation rates were 22% for levonorgestrel intra-uterine systems (LNG-IUS) 52 mg, 25% for LNG-IUS 19.5 mg, 39% for copper IUDs and 47% for subdermal implants. Common reasons for discontinuation were: alterations in bleeding pattern (68%), abdominal pain (32%), headache or mood fluctuation (24%) and a preference for natural contraceptive methods (23%). Factors associated with discontinuation for reasons other than pregnancy wish were: age between 30 and 34 years old (OR 5.1, 95% CI [1.26–20.48]) and a history of sexual, physical and/or psychological abuse (OR 3.16, 95% CI [1.60–6.23]). A high educational level (OR 0.33, 95% CI [0.12–0.89]) was associated with a lower risk of discontinuation. Conclusion: The discontinuation rates of LARCs are high. Better counselling might prevent premature discontinuation. SHORT CONDENSATION: Despite their effectiveness premature discontiunuation rates of LARC are high, especially for subdermal implants. The most mentioned reason for discontinuation is alternation in bleeding partern. Better couneling by general practitioners and research into the underlying disturbed endometrial mechanism have to be done. [ABSTRACT FROM AUTHOR]

Purpose: While many women worldwide use contraception, there is a paucity of research on individual experiences of side effects. To address this gap, we investigated individual's contraception experiences. Methods: Women aged 18 to 35, living in the UK were invited to participate in an online survey on contraception. Free text responses were collected. Through a directed content analysis approach, we developed a coding framework (based on existing literature and initial response review) including six themes; method(s) of contraception, side effect(s) experienced, impact of side effect(s), timing of side effect(s), interactions with healthcare practitioners, and trial-and-error. Results: Overall, 337 participants provided free-text responses. Side effect experiences and impacts varied greatly between individuals and contraceptives. Most participants described negative effects, including mental health issues and bleeding problems. However, some shared positive experiences mainly related to bleeding management or the absence of side effects. Participants described how side effects often varied or appeared over time. Some participants felt unheard by healthcare practitioners. Conclusions: This study highlights how specific contraceptive experience is to the individual. We advocate for a patient-centred approach to contraceptive counselling. Practitioners should play an active role in improving contraception prescription, acknowledging the diverse experiences and preferences of patients. SHORT CONDENSATION: This UK based study highlights the individual nature of contraceptive experiences and how side effects are often overlooked by healthcare practitioners emphasising the need for patient-centred contraceptive counselling that considers the impacts on physical and mental health. [ABSTRACT FROM AUTHOR]

Drug discovery relies on the precise prognosis of drug–target interactions (DTI). Due to their ability to learn from raw data, deep learning (DL) methods have displayed outstanding performance over traditional approaches. However, challenges such as imbalanced data, noise, poor generalization, high cost, and time-consuming processes hinder progress in this field. To overcome the above challenges, we propose a DL-based model termed DrugSchizoNet for drug interaction (DI) prediction of Schizophrenia. Our model leverages drug-related data from the DrugBank and repoDB databases, employing three key preprocessing techniques. First, data cleaning eliminates duplicate or incomplete entries to ensure data integrity. Next, normalization is performed to enhance security and reduce costs associated with data acquisition. Finally, feature extraction is applied to improve the quality of input data. The three layers of the DrugSchizoNet model are the input, hidden and output layers. In the hidden layer, we employ dropout regularization to mitigate overfitting and improve generalization. The fully connected (FC) layer extracts relevant features, while the LSTM layer captures the sequential nature of DIs. In the output layer, our model provides confidence scores for potential DIs. To optimize the prediction accuracy, we utilize hyperparameter tuning through OB-MOA optimization. Experimental results demonstrate that DrugSchizoNet achieves a superior accuracy of 98.70%. The existing models, including CNN-RNN, DANN, CKA-MKL, DGAN, and CNN, across various evaluation metrics such as accuracy, recall, specificity, precision, F1 score, AUPR, and AUROC are compared with the proposed model. By effectively addressing the challenges of imbalanced data, noise, poor generalization, high cost and time-consuming processes, DrugSchizoNet offers a promising approach for accurate DTI prediction in Schizophrenia. Its superior performance demonstrates the potential of DL in advancing drug discovery and development processes. [ABSTRACT FROM AUTHOR]

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Background/Objectives: Owing to the growing use of immune checkpoint inhibitors (ICIs) in the treatment of cancer, a wide spectrum of toxicity has arisen among cancer patients. Yet, limited ICI toxicity-related research is currently conducted in our region. Methods: This is a retrospective observational study conducted on adult cancer patients who received at least one cycle of ICI single therapy. Toxicity profiles of different ICI monotherapies were described and compared, and their association with different risk factors was assessed. SPSS version 28 was used for statistical analyses, and p < 0.05 was considered statistically significant. Results: A total of 428 patients were treated with anti-PD1 (nivolumab [n = 221, 51.6%] and pembrolizumab [n = 126, 29.5%]) or anti-PD-L1 (atezolizumab [n = 78, 18.2%] and durvalumab [n = 3, 0.7%]). Pneumonia was the most common complication (10%), followed by acute kidney injury (AKI; 8.2%) and hepatitis (7.9%). The proportion of hepatitis cases was significantly higher among atezolizumab compared to nivolumab-, pembrolizumab-, and durvalumab-treated patients (17.95% vs. 7.7% vs. 2.4% vs. 0.0%, respectively; p < 0.001). Gastrointestinal complication (colitis) was detected in 3.3% of patients with a significant difference between treatment groups (4.5%, 1.6%, 1.3%, and 33.3% in nivolumab, pembrolizumab, atezolizumab, and durvalumab, respectively; p = 0.008). Cardiac complications occurred in 1.2% of patients with a significant difference between treatment groups (0.5% in the nivolumab, 3.8% in the atezolizumab, 33.3% in the durvalumab, and none in the pembrolizumab groups (p < 0.001)). Musculoskeletal side effects, including both arthralgia and fatigue, were the most-reported side effects by 39.5% of patients, with significantly higher arthralgia complainers only in nivolumab (7.7%) compared to other treatment groups (0%, 2.6%, and 0% in pembrolizumab, atezolizumab, and durvalumab, respectively, p = 0.007). Hepatic, cardiovascular, hematological, respiratory, renal, gastrointestinal complications, thyroid complications, and dermatological side effects were found to occur on weeks 6, 7.5, 8, 8, 10, 10, 10.5, and 12 after treatment initiation, respectively, with no significant difference between treatment groups. Despite that, hepatitis and AKI tended to occur earlier with atezolizumab (week 2, p = 0.084) and pembrolizumab (week 2, p = 0.062), respectively, compared to their comparators. The female gender and a history of hepatitis were found to increase the odds of hepatic complication with anti-PD1 or anti-PD-L1 use [OR = 2.71; 95% CI 1.07–6.85, OR = 11.14; 95% CI 3.46–35.88, respectively]. Previous exposure to cancer therapy only was found to increase the odds of developing pneumonia among the treated patients [OR = 3.08; 95% CI 1.12–8.85]. Having hematological malignancy influenced the odds of hematological complications positively (either neutropenia or thrombocytopenia) compared to solid malignancies when patients were treated with anti-PD1 or anti-PD-L1 [OR = 17.18; 95% CI 4.06–72.71]. Finally, the female gender was found to positively associate with the odds of nausea/vomiting and fatigue secondary to anti-PD1 or anti-PD-L1 administration [OR = 2.08; 95% CI 1.34–3.21, OR = 1.65; 95% CI 1.09–2.51, respectively]. On the other hand, previous exposure to cancer therapy was found to reduce the risk of having arthralgia with anti-PD1 or anti-PD-L1 administration [OR = 0.344; 95% CI 0.121–0.974]. Conclusions: Treatment with anti-PD1 or anti-PD-L1 was associated with a spectrum of complications and side effects. Several risk factors have been identified to impact their occurrence. ICI toxicities and risk factors influencing their odds should be recognized and considered in clinical practice, as this could help in individualizing therapeutics regimens and avoiding treatment interruption. [ABSTRACT FROM AUTHOR]

Simple Summary: Breast cancer survivors face unique challenges and sequelae that can arise due to their disease or treatment and that often persist for many years. Physical, emotional, psychological, and social toxicities are common in breast cancer survivors, which can lead to significant negative impacts on quality of life. While many studies have investigated the relationship between various breast cancer sequelae and quality of life, very few studies have investigated the patient, disease, and treatment factors underlying the likelihood of experiencing side effects in breast cancer survivorship. This retrospective study aims to describe the sequelae, side effects, and toxicities experienced by Canadian breast cancer survivors at a breast cancer survivorship clinic at an academic tertiary cancer centre and to identify potential risk factors which may be associated with increased side effect burden. This will potentially help to predict the extent of a patient's anticipated need for clinical services, improving the current breast cancer survivorship program's ability to provide efficient and effective care. Background/Objectives: This study describes the sequelae, side effects, and toxicities experienced by Canadian breast cancer survivors at a breast cancer survivorship clinic at a tertiary academic cancer centre and identifies potential risk factors which may be associated with increased side effect burden. Methods: A retrospective chart review was performed of adult patients treated at the Sunnybrook Breast Cancer Survivorship Clinic from 6 July 2022, to 30 September 2023 (n = 435). Results: Most patients (72.6%) reported at least one side effect impacting their quality of life, and a smaller majority (55.4%) reported two or more side effects. The most common symptoms experienced were anxiety (29.4%), chronic pain (23.9%), hot flashes (21.4%), and fear of recurrence (19.8%). Older age was strongly correlated with a lower likelihood of experiencing greater side effect burden (p < 0.01). Patients who underwent chemotherapy were significantly more likely to experience higher side effect burden than patients who did not. Current smokers were more likely than nonsmokers or past smokers to have a higher burden, for both physical (p < 0.01) and psychological side effects (p < 0.01). The multivariate analysis demonstrated that younger age was strongly associated with greater side effect burden, higher likelihood of psychological and physical symptoms, and greater likelihood of requiring close follow-up. Conclusions: The results highlight the need for survivorship resources tailored to survivors under the age of 55 and the importance of referring smokers to smoking cessation programs. Additional research is required to explore the significant reluctance among patients regarding discharge. Future studies should examine the acute needs of younger breast cancer survivors and investigate the impact of smoking and treatment modalities on the side effect burden. [ABSTRACT FROM AUTHOR]

Simple Summary: We explored the symptoms and side effects that can result from using BCG (an immunotherapy agent) to treat bladder cancer. We concluded that when BCG was combined with chemotherapy and at lower doses, the symptoms and side effects were less reported. These findings allow clinicians to improve counselling of patients regarding the management course and side effects for treating NMIBC. Background/Objectives: Knowledge of the symptoms and side effects (SSEs) of Bacille Calmette–Guerin (BCG) therapy for non-muscle invasive bladder cancer (NMIBC) is critical when establishing selecting appropriate therapies for patients. The aim of our study was to systematically review the common patient-reported SSEs associated with BCG-based and other intravesical chemotherapy treatment options for NMIBC. Methods: A systematic search of AMED, MEDLINE, EMBASE, PsycINFO, Web of Knowledge, and Scopus was conducted from inception to July 2024. The PRISMA process was followed. Prospective studies with an adult cohort that assessed SSEs through direct patient reports with standardized patient-reported outcome measures were included in this study. A narrative synthesis was performed to compare the frequency of SSEs reported by treatment options. Statistical analysis was performed using chi square and Fisher's exact tests, with statistical significance at p < 0.05. Results: Thirty-four studies met the eligibility criteria. The main findings indicated that BCG induction is more toxic than BCG induction with maintenance; however, severe SSEs resulting in treatment cessation occurred almost twice as often in patients on BCG induction with maintenance. Patients who received full-dose BCG were more likely to have SSEs compared to those receiving a low dose. BCG monotherapy alone caused more SSEs compared to BCG with chemotherapy. Patients reported more SSEs with BCG compared to chemotherapy alone for induction with maintenance. Limitations of the study include the varied length of maintenance regimes affecting nature of data reported. Conclusions: The findings of this study allow for improved counselling of patients regarding expected side effects in accordance with their recommended treatment options for NMIBC. [ABSTRACT FROM AUTHOR]

Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with poor prognosis, primarily due to its immunosuppressive tumor microenvironment (TME), which contributes to treatment resistance. Recent research shows that the microbiome, including microbial communities in the oral cavity, gut, bile duct, and intratumoral environments, plays a key role in PDAC development, with microbial imbalances (dysbiosis) promoting inflammation, cancer progression, therapy resistance, and treatment side effects. Microbial metabolites can also affect immune cells, especially natural killer (NK) cells, which are vital for tumor surveillance, therapy response and treatment-related side effects. Dysbiosis can affect NK cell function, leading to resistance and side effects. We propose that a combined biomarker approach, integrating microbiome composition and NK cell profiles, can help predict treatment resistance and side effects, enabling more personalized therapies. This review examines how dysbiosis contributes to NK cell dysfunction in PDAC and discusses strategies (e.g., antibiotics, probiotics, vaccines) to modulate the microbiome and enhance NK cell function. Targeting dysbiosis could modulate NK cell activity, improve the effectiveness of PDAC treatments, and reduce side effects. However, further research is needed to develop unified NK cell–microbiome interaction-based biomarkers for more precise and effective patient outcomes. [ABSTRACT FROM AUTHOR]

The placebo effect, i.e., the psychobiological response arising from administering an inert treatment, influences various domains, such as pain perception and emotional regulation. Positive framing might enhance this effect. This study tested whether the effect of an active placebo (mimicking drug side effects to enhance treatment credibility) on is generalized between two different contexts of sadness induction and if positive framing of side effects enhances this effect. Ninety-six healthy participants were randomly assigned to one of three groups: Placebo+positive framing (PPF), Placebo+standard information (PSI), or no treatment control (NTC). Participants underwent a sadness induction protocol during an in-person lab session and a 20-min online follow-up at home six hours later. Primary outcome was self-reported sadness, secondary outcome was self-reported side effects. Both the PPF and PSI groups showed a significant decrease in sadness compared to the NTC group after placebo administration during the lab session (p < 0.001) and at follow-up (p < 0.05). At follow-up, only the PPF group did not experience a significant increase in sadness. Positive framing did not improve side effect tolerability. Self-reported measures introduce subjective bias. The sample restriction to healthy volunteers limits generalizability. The six-hour period may not capture clinically relevant long-term effects. The active placebo nasal spray effectively reduced sadness, with effects persisting for six hours and across different contexts. Positive framing did not enhance side effect tolerability but may have helped maintain effectiveness at follow-up. Further research is needed in clinical populations and to explore long-term effects. • The placebo effect protects from sadness generalized between two different contexts. • The placebo effect persists over two different sadness induction methods. • The placebo effect lasts at least six hours with one administration. • Framing side effects as onset sensations may have helped to maintain this effect. [ABSTRACT FROM AUTHOR]

Background: The rising use of antidepressants is critical for managing mental health disorders, but weight gain is a concerning side effect, particularly with certain classes like TCAs and SSRIs. This study aims to investigate weight changes in Omani patients prescribed paroxetine, fluoxetine, mirtazapine, or venlafaxine. Method: A cross-sectional study conducted from January to June 2023 at Sultan Qaboos University Hospital recruited adults with mental disorders on these medications. Weight measurements were taken at baseline and follow-up, with clinically significant weight gain defined as a ≥ 7% increase. Results: A total of 135 participants were analyzed, showing a mean weight gain of 5.54 kg, with 60.7% experiencing significant weight gain. Mirtazapine and paroxetine exhibited the highest average weight increases (7.51 kg and 8.05 kg, respectively) compared to fluoxetine (0.69 kg) and venlafaxine (4.32 kg). No significant demographic factors influenced weight changes (p = 0.213). Conclusion: The study highlights significant weight gain among Omani patients on antidepressants, particularly mirtazapine and paroxetine. This underscores the importance of monitoring weight in clinical practice and necessitates further investigations into individualized treatment strategies to manage both mental health and weight-related concerns. [ABSTRACT FROM AUTHOR]

Introduction: The survival in early breast cancer (BC) has been significantly improved thanks to numerous new drugs. Nevertheless, the information about the need for systemic therapy, especially chemotherapy, represents an additional stress factor for patients. A common coping strategy is searching for further information, traditionally via search engines or websites, but artificial intelligence (AI) is also increasingly being used. Who provides the most reliable information is now unclear. Material and Methods: AI in the form of ChatGPT 3.5 and 4.0, Google, and the website of PINK, a provider of a prescription-based mobile health app for patients with BC, were compared to determine the validity of the statements on the five most common side effects of nineteen approved drugs and one drug with pending approval (Ribociclib) for the systemic treatment of BC. For this purpose, the drugs were divided into three groups: chemotherapy, targeted therapy, and endocrine therapy. The reference for the comparison was the prescribing information of the respective drug. A congruence score was calculated for the information on side effects: correct information (2 points), generally appropriate information (1 point), and otherwise no point. The information sources were then compared using a Friedmann test and a Bonferroni-corrected post-hoc test. Results: In the overall comparison, ChatGPT 3.5 received the best score with a congruence of 67.5%, followed by ChatGPT 4.0 with 67.0%, PINK with 59.5%, and with Google 40.0% (p < 0.001). There were also significant differences when comparing the individual subcategories, with the best congruence achieved by PINK (73.3%, p = 0.059) in the chemotherapy category, ChatGPT 4.0 (77.5%; p < 0.001) in the targeted therapy category, and ChatGPT 3.5 (p = 0.002) in the endocrine therapy category. Conclusions: Artificial intelligence and professional online information websites provide the most reliable information on the possible side effects of the systemic treatment of early breast cancer, but congruence with prescribing information is limited. The medical consultation should still be considered the best source of information. [ABSTRACT FROM AUTHOR]

Plant secondary metabolites (PSMs) are a diverse group of bioactive compounds, including flavonoids, polyphenols, saponins, and terpenoids, which have been recognised for their critical role in modulating cellular functions. This review provides a comprehensive analysis of the effects of PSMs on mitochondrial health, with particular emphasis on their therapeutic potential. Emerging evidence shows that these metabolites improve mitochondrial function by reducing oxidative stress, promoting mitochondrial biogenesis, and regulating key processes such as apoptosis and mitophagy. Mitochondrial dysfunction, a hallmark of many pathologies, including neurodegenerative disorders, cardiovascular diseases, and metabolic syndrome, has been shown to benefit from the protective effects of PSMs. Recent studies show that PSMs can improve mitochondrial dynamics, stabilise mitochondrial membranes, and enhance bioenergetics, offering significant promise for the prevention and treatment of mitochondrial-related diseases. The molecular mechanisms underlying these effects, including modulation of key signalling pathways and direct interactions with mitochondrial proteins, are discussed. The integration of PSMs into therapeutic strategies is highlighted as a promising avenue for improving treatment efficacy while minimising the side effects commonly associated with synthetic drugs. This review also highlights the need for future research to elucidate the specific roles of individual PSMs and their synergistic interactions within complex plant matrices, which may further optimise their therapeutic utility. Overall, this work provides valuable insights into the complex role of PSMs in mitochondrial health and their potential as natural therapeutic agents targeting mitochondrial dysfunction. [ABSTRACT FROM AUTHOR]

Background: Dimethyl fumarate (DMF) and diroximel fumarate (DRF) are two treatments used for multiple sclerosis (MS) that have been shown to be effective in controlling MS patients. DRF was introduced in 2019 with the aim of decreasing the gastrointestinal side effects caused by DMF. Few real-life studies verify the data provided in the clinical trials. Methods: A retrospective descriptive study was conducted on MS patients at the Hospital Universitario Torrecárdenas under treatment with DRF and DMF. Demographic, clinical, and analytical variables were studied and compared between groups. Results: A total of 60 patients were recruited, 30 with each treatment, observing similar baseline characteristics. Fewer gastrointestinal (GI) effects were observed in the DRF group, while more infections were detected in the DMF group. We recorded lower levels in the DRF group, with four cases of moderate-severe lymphopenia in the DRF group vs. none in the DMF group. In addition, we observed a decrease in lymphocytes after the change from DMF to DRF in patients with a change. Conclusions: Our real-life analysis of patients treated with DMF or DRF supports several studies' findings regarding decreased GI side effects with DRF vs. DMF without decreasing efficacy. However, our data show a greater reduction in lymphocytes in patients with DRF compared to DMF, so more studies are necessary. [ABSTRACT FROM AUTHOR]

Objective: To assess and compare the frequency of psychotherapeutic side effects in different psychotherapeutic approaches. Method: Side effects were assessed across 17 domains through structured interviews with 45 outpatients in cognitive-behavior, psychodynamic, and psychoanalytic psychotherapy. Results: Almost every patient (95.6%) reported at least one side effect, with a mean of 4.7 affected domains. Most frequent complaints were that problems were seen as more complex (60.0–80.0%), worsening of pre-existing symptoms (46.7–60%), occurrence of new symptoms (20.0–53.3%), feeling uncomfortable in treatment (33.3–40.0%), tensions with therapist (26.7–46.7%), as well as conflicts with current family and with family of origin (both 13.3–46.7%). Differences between therapeutic orientations were mostly non-significant. Conclusion: Psychotherapy is regularly accompanied by side effects, independent of different theoretical orientations. Psychotherapists need to be familiar with side effects in order to inform patients about treatment-associated risks and to recognize and manage side effects. [ABSTRACT FROM AUTHOR]

Background: The first mass vaccination program for COVID-19 in India started on January 16, 2021. Initially, Covaxin and Covishield were used. Later, the Government of India has approved the usage of Corbevax, a Hyderabad-based biological E SARS-CoV-2 (COVID-19) vaccine among 12- to 14-year age group from March 16, 2022. Corbevax vaccination was started in our hospital setting on March 19, 2022, for 12- to 14-year age group. Monitoring safety of any vaccine is of importance in a real-world setting. Limited study has been performed till date on side effects of Corbevax vaccine. Therefore, this study has been planned to assess the side effects after Corbevax vaccination among 12- to 14-year age group in a tertiary care hospital setting in Meerut district. To assess the side effects after Corbevax vaccination among 12- to 14-year age group in a tertiary care hospital setting in Meerut district. Tertiary care hospital setting and cross-sectional study design. Methods and Material: A cross-sectional study was conducted among 270 study participants. Sample size was calculated assuming 50% prevalence of side effects after vaccination. Study subjects were selected by using simple random sampling among the beneficiaries of a tertiary care center. Data were collected using a pretested semistructured questionnaire. Proportions, Chi-square test. Results: Of all the participants, 41.48% had developed side-effects with pain at site of injection being the most commonly reported symptom (64.29%), and about half among those affected had resolved spontaneously. Conclusions: The vaccine causes only mild symptoms and is safe for use in children. [ABSTRACT FROM AUTHOR]

Enzalutamide is a potent androgen receptor signalling inhibitor. Enzalutamide treatment is effective in various stages of prostate cancer. However, the treatment is associated with side effects of the central nervous system like fatigue, cognitive impairment and depression, which can have a large impact on the quality of life. This study investigated whether a reduced dose of enzalutamide (120 mg once daily (OD)) results in fewer side effects compared to the standard dose of enzalutamide (160 mg OD) in frail patients with prostate cancer. Therefore, 52 patients were randomised between both dosages. Patients who were treated with the reduced dose had significantly lower fatigue after 24 weeks compared to those with the standard dose (difference FACIT-Fatigue questionnaire 6.2; 95%-CI 1.4–11.0; p = 0.01). Patients treated with the standard dose experienced increasing fatigue, cognitive side effects and depressive symptoms after 24 weeks of treatment compared to the start of the treatment. In patients with the reduced dose, these symptoms remained stable over time. To conclude, a reduced dose of enzalutamide results in less fatigue, cognitive side effects and depressive symptoms in frail patients with prostate cancer, without any indication of interference with efficacy endpoints. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to determine the efficacy and safety of low-dose radiotherapy (LDR) for postoperative local chest wall recurrence of breast cancer. Methods: The records of 52 patients with postoperative local chest wall recurrent breast cancer treated at our cancer center from January 2019 to December 2022. The t-test was used to compare the means of the LDR group and non LDR group. Categorical data were compared using the chi-square test. The Kaplan-Meier method were used to determine the factors associated the survival. Results: Compared to patients who did not undergo LDR, patients in the LDR group showed a higher incidence of grade I side effects in their skin and soft tissue systems (p = 0.002), a significant reduction in grade II side effects (p < 0.05), and no grade III side effects. Compared with the non LDR group, the complete response rates were 42.3% vs. 38.5%, p = 0.777, the partial response rates were 53.8% vs. 50.0%, p = 0.781, and the objective relief rates were 96.2% vs. 88.5%, p = 0.833, respectively. The 3-year overall survival rate, local recurrence free survival rate, distant metastasis-free survival rate and disease-specific survival rate comparison between LDR group and non LDR group was 54.8% vs. 55.8%, p = 0.845 and 54.2% vs. 52.9%, p = 0.751, 67.9% vs. 51.9%, p = 0.097 and 39.2% vs. 49.6%, p = 0.993, respectively. Conclusion: Compared with traditional radiotherapy, LDR pre-irradiation has better tolerance and efficacy in patients with local chest wall recurrence of breast cancer after operation. [ABSTRACT FROM AUTHOR]